Stereotactic biopsy complicated by pneumocephalus and acute pulmonary edema

Jonathan Roth, Itzik Avneri, Adi Nimrod, Andrew A. Kanner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: The aim of this study was to describe pneumocephalus as a rare complication of stereotactic biopsy and as a possible cause of acute neurogenic pulmonary edema. Case Description: A case of frameless stereotactic biopsy complicated by pneumocephalus presenting with acute lung injury 48 hours after the procedure. A frameless stereotactic procedure was performed in the standard fashion. Immediate postoperative CT showed no intracranial air except for a gas inclusion at the biopsy site within the lesion. The skin staple placed at the end of surgery on the skin incision was removed 36 hours later. A CT scan performed 48 hours postoperatively showed new pneumocephalus. The patient exhibited acute respiratory distress but no new neurologic symptoms. There was no detectable systemic cause for the pulmonary edema. The patient received supportive respiratory treatment and fully recovered. Conclusion: Pneumocephalus is apparently a rare complication of stereotactic brain biopsy and one that may result from early removal of the skin staple or suture. The occurrence of acute neurogenic pulmonary edema may be attributed to the pneumocephalus.

Original languageEnglish
Pages (from-to)573-576
Number of pages4
JournalSurgical Neurology
Issue number5
StatePublished - Nov 2007
Externally publishedYes


  • Neurogenic pulmonary edema
  • Pneumocephalus
  • Stereotactic biopsy


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